<%@ page language="java" contentType="text/html; charset=UTF-8"
    pageEncoding="UTF-8"%>
<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
<title>导入医保问题数据</title>
</head>
<body>
<div style="width:982px;margin:0 auto;">
<h3 align="center">医保问题数据</h3>
<div id="medins_id"></div>
</div>

<div class="modal fade" id="edit_modal" tabindex="-1" role="dialog" aria-labelledby="myModalLabel" aria-hidden="true">
  <div class="modal-dialog">
    <div class="modal-content">
      <div class="modal-header">
        <button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">&times;</span></button>
        <h4 class="modal-title" >问题数据修改</h4>
      </div>
				<div class="modal-body">
				<form class="form-horizontal" role="form">
					<div class="form-group">
						<label class="col-lg-4 control-label">入院日期 :</label>
						<div class="col-lg-4">
							<input type="text" class="form-control" id="in_date" placeholder="输入格式：2017-01-01">
							<span class="required" style="float: right;">*</span>
						</div>
					</div>
					<div class="form-group">
						<label class="col-lg-4 control-label">出院日期 :</label>
						<div class="col-lg-4">
							<input type="text" class="form-control" id="out_date" placeholder="输入格式：2017-01-01">
							<span class="required" style="float: right;">*</span>
						</div>
					</div>
				</form>
			</div>
				<div class="modal-footer">
        <a id="submit_btn" class="btn btn-success" data-dismiss="modal">提交</a>
        <a class="btn btn-default" data-dismiss="modal">取消</a>
      </div>
    </div>
  </div>
</div>

<script type="text/javascript" src="<%=request.getContextPath() %>/js/data/medInsComplete.js"></script>
</body>
</html>